Background: Testicular Ischemia reperfusion injury(IRI) is a major pathophysiological process of surgical reduction after testicular torsion, and oxidative stress is the main injury factor. However, the role of BMSCs-derived exosomes in testicular IRI and its mechanism have not been reported. In this study, we investigated the protective effect of bone marrow mesenchymal stem cell-derived exosomes against testicular ischemia-reperfusion injury.Methods: BMSCs were isolated, cultured and identified by primary culture method. Exosomes derived from BMSCs were extracted by ultra-high speed centrifugation method. A testicular IRI model was established in male SD rats. Thirty healthy male SD rats were randomly divided into three groups. Group A: Sham group, group B: normal saline treatment group (I/R+NS), group C: BMSCs-derived exosomes (100 ug/mL) treatment group (I/R+ BMSCs-EXO). Finally take each side (left) of rat torsion by using optical microscope to detect testicular tissue pathology grade and fine structure of organization structure, adopt the method of biochemical determination of groups of testicular tissue MDA and NOS, SOD and CAT activity and T - AOC level.Results: BMSCs were successfully isolated and cultured from rat bone marrow, and exosomes secreted by BMSCs were successfully extracted. In animal model, Compared with the normal spermatogenic structure of testis in group A (Sham), the spermatogenic structure of testis in group B (I/R+NS) was obviously damaged to varying degrees, while the spermatogenic structure of testis in group C (I/R+ BMSCs-EXO) was improved to A certain extent (P<0.05). In the biochemical indexes of testis tissue, the contents of MDA and NOS in group B (I/R+NS) were significantly increased compared with group A (Sham), while the activities of SOD and CAT and T-AOC were decreased compared with group A (Sham) (P<0.05). In the exosome-treated group C (I/R+ BMSCs-EXO), compared with the normal saline treatment group B, The contents of MDA and NOS were decreased to a certain extent, while the activities of SOD and CAT and the level of T-AOC were increased (P<0.05).Conclusion: BMSCs-derived exosomes can be absorbed by rat spermatogonia and have antioxidant and anti-inflammatory protective effects against testicular ischemia-reperfusion injury。